（碎锦）
夫毒必由脓而化，故有脓则生，无脓则死。然脓者，气之所聚，血之变也，是以顶
肥光润，根窠血聚者，则自有脓生之兆也。若见顶陷灰白，根窠血散者，则自无脓，死
之征也。
凡四五朝，身发潮热，根红顶白，仪食俱进，二便如常，神气安静者，吉。一痘至
养浆，尤宜守诸禁戒，盖在起发之时，其病未久，气血犹强，足以御其日乖戾之气，至
此则气耗血亏，精神减损，少有乖戾，不能任之，况正在秀发之时，而欲成实之候耶！
一痘至五六日，毒化成浆，初色发白，次变色绿，后如苍腊，肥满光泽，根窠红活，将
手按之，其皮坚硬，其浆脓软，更无他症者，吉。一凡根窠红活，为阴血得宜，痘顶
变白，为阳气得宜，乃气血交会，阴阳迭运，兼之变白之中而脓浆淳浓者，是血所化
而毒所附，则阳中有阴，此乃阴阳交泰，吉之兆也。否则，内为空仓，外为茱萸，气血
俱竭，其欲不死也难矣。一凡不先不后，肿过颈项，浆到胸前，其脓方带黄色者，此为
真浆，其阳物头上，亦要浆先充满为妙。一两手足背浆，亦要满足，盖此属脾胃，否
则，临靥必不能食而多变症。一凡看痘，更须详察痘母光润，脓浆充贯，则虽余痘次
之，终亦无害，但宜补化为主。
一痘起胀，光泽可观，然以手摸之，则软而皮皱者，此浆未满而气馁，即用保元托
浆。否则，难靥，甚至发痒。一痘灰白，浆不满足，皮薄易破，欲成倒塌者，急与保元
汤，加桂米主之。一痘色红紫，浆不满足，欲成干枯黑陷者，急与归芎生地之类，活血
凉血，充托灌浆。一痘遍身灌脓忽变灰白者，此属虚寒也，宜温补托里。如变红紫
者，此系实热也，宜凉血清表，然亦有因邪触者，其来必暴，不可不详。一痘已起胀灌
脓，至七八日，大便久闭者，急与归尾枳壳生地黄芩之类。否则。至于靥时，必发大热
而死。一痘灌脓，作痛不止，其症有二，有气滞作痛者，痘必不光泽，治宜行滞。如血
热作痛者，痘必红紫，治宜凉血，然不可太甚，恐血滞浆停耳。一凡两颊鼻准额角高突
之处，稠密看，是五脏毒瓦斯所聚，最易擦破，此地一伤，则诸痘尽伏，毒即内攻，故
宜切为守获。如误抓破，即奖将牢封，仍服内托。若得复起充灌，诸痘如常，或于空
处，增出赠痘，点虽细小，易灌易回，是余毒得以复出矣。又为吉兆。一凡眼眶紫黑
者，是枭毒攻冲而肝受损也。或因久咳亦然。一方灌脓，即有生意太早者，须防元气
不足，宜用保元而兼托里，或痘燥者为血虚，尤宜养血。一灌脓时声音低细者，不
妨。如忽热声哑，腹胀气粗者，其四夫紧要之处，必有疔，或贼痘，宜急查看，挑破，
以油胭脂珍珠末牢封之。一头面行浆而下部空虚，则毒标于上，可免危亡之患。若手足
先贯而上部空虚，则毒陷于内，难免丧生之害。一痘破成坑者，此内陷也。用白龙散以
外敷，而内补托可也。若连片皆有，或处处有二三个者，凶。一方将灌脓，口渴烦热，
发呛喘逆者，凶。一灌脓时，痘似充满而中实空软者，此名空仓痘，极恶症也。若痘中
略有清水，板窠起胀，血附红活者，急用参 芎归人乳之类以救之。一灌脓时，发泡如
弹子大者，急用白术茯苓之类。壮脾胃以利皮肤之水。若发紫泡者，不治。一贯浆时，
成片作烂，脓水不干者，宜大补气血，兼渗水之药，外用败草散敷之。一贯浆时，色
白。如水晶，内无脓汁者，切勿轻视，十一二日、宜防痒塌，十四五日，必致命终，宜
早投内托散，加丁香干姜，或木香散，加糯米乳酒之类。一七八日间，其浆已成而寒战
切牙者，此里虚也。当保元汤，加丁桂主之。如战止结痂者，佳。一贯浆已满，热毒
已解至收靥数日不焦者。若痘色如初，此亦无如，非气虚，不能收敛，或脾虚不能渗
湿，但用八珍加补脾利水之药，而痘自敛矣。
（碎锦篇）
毒邪必须通过化脓才能化解，所以有脓则生，无脓则死。然而脓是气聚集、血变化的产物，因此痘顶丰满光亮润泽，根部周围血液汇聚的，自然有化脓的征兆。如果见到痘顶凹陷、颜色灰白，根部周围血液散乱的，则是没有脓液，这是死亡的征象。
凡是发病四五天后，身体出现定时发热，痘根红活、痘顶发白，饮食正常，大小便如常，精神气息安定的，为吉兆。一等到痘进入养浆阶段，尤其应当遵守各种禁忌，因为在起发之时，病程不久，气血还强盛，足以抵御每日乖戾的邪气；到了这个阶段，气耗血亏，精神减损，稍有违逆就不能承受，何况正处于秀发、将要成实的时候呢！
一等到痘发病五六天，毒邪化成浆液，初时颜色发白，随后变为绿色，后来像苍蜡一样，丰满光泽，根部红活，用手按压，皮坚硬而浆液柔软，没有其他症状的，为吉。凡根部红活，说明阴血适宜；痘顶变白，说明阳气适宜，这是气血交会、阴阳交替运行，并且在变白的过程中脓浆浓稠纯正，这是血所化而毒所依附，阳中有阴，这是阴阳交泰，是吉祥的征兆。否则，内部成为空仓，外部像茱萸一样干枯，气血俱竭，想要不死也很难了。
凡是不先不后，肿胀超过颈项，浆液到达胸前，其脓液略带黄色的，这称为真浆，生殖器头部也要浆液先充满才好。两手足背的浆液，也要饱满，因为这里属于脾胃管辖，否则临结痂时必然不能进食且多变症。凡看痘，更须详细观察“痘母”（主痘）是否光润，脓浆充贯，那么其余的痘虽然次之，最终也无害，但宜以补益化毒为主。
一痘起胀，光泽可观，但以手摸之，却软而皮皱的，这是浆液未满而气馁，应立即用保元托浆法。否则，难以结痂，甚至发痒。一痘色灰白，浆液不满足，皮薄易破，欲成倒塌状的，急用保元汤，加桂米主治。一痘色红紫，浆液不满足，欲成干枯黑陷状的，急用当归、川芎、生地之类，活血凉血，充托灌浆。一痘遍身灌脓忽变灰白的，这属于虚寒，宜温补托里。如果变红紫的，这属于实热，宜凉血清表，但也有因邪气触动引起的，其来势必暴，不可不详察。一痘已起胀灌脓，到七八天，大便久闭的，急用归尾、枳壳、生地黄、黄芩之类。否则，到了结痂时，必发大热而死。一痘灌脓，疼痛不止，其症有两种：有气滞作痛的，痘必不光泽，治疗宜行滞。如血热作痛的，痘必红紫，治疗宜凉血，然不可太甚，恐怕导致血滞浆停。
凡两颊、鼻准、额角高突之处，稠密看，是五脏毒瓦斯所聚，最易擦破，此地一伤，则诸痘尽伏，毒即内攻，故宜切实守护。如果误抓破，即将疮口牢固封闭，仍服内托药。若得重新起发充灌，诸痘如常，或在空处增出赠痘（额外发出的痘），点虽细小，易灌易回，是余毒得以复出，这也是吉兆。凡眼眶紫黑的，是枭毒攻冲而肝受损。或因久咳亦然。一方灌脓，就有生机显露太早的，须防元气不足，宜用保元汤兼托里，或痘燥的为血虚，尤宜养血。
一灌脓时声音低细的，不妨碍。如果忽然发热声哑，腹胀气粗的，其四肢紧要之处，必有疔疮，或贼痘，宜急查看，挑破，以油胭脂珍珠末牢固封闭。一头面行浆而下部空虚，则毒标于上，可免危亡之患。如果手足先贯而上部空虚，则毒陷于内，难免丧生之害。一痘破成坑的，这是内陷。用白龙散外敷，而内服补托药即可。如果连片皆有，或处处有二三个的，凶。一方将灌脓，口渴烦热，发呛喘逆的，凶。一灌脓时，痘似充满而中实空软的，这名叫空仓痘，极恶症也。如果痘中略有清水，板窠起胀，血附红活的，急用人参、川芎、当归、人乳之类来救它。一灌脓时，发泡如弹子大的，急用白术、茯苓之类，壮脾胃以利皮肤之水。如果发紫泡的，不治。一贯浆时，成片作烂，脓水不干者，宜大补气血，兼渗水之药，外用败草散敷之。一贯浆时，色白如水晶，内无脓汁者，切勿轻视，十一二日宜防痒塌，十四五日必致命终，宜早投内托散，加丁香、干姜，或木香散，加糯米、乳酒之类。一七八日间，其浆已成而寒战切牙的，这是里虚。当用保元汤，加丁香、肉桂主治。如果战止结痂的，佳。一贯浆已满，热毒已解至收靥数日不焦的，如果痘色如初，这也无妨，非气虚不能收敛，就是脾虚不能渗湿，只用八珍汤加补脾利水的药，而痘自敛矣。
(Sui Jin Chapter)
Toxic pathogens must be resolved through suppuration; thus, the presence of pus indicates life, while its absence indicates death. However, pus is the accumulation of Qi and the transformation of Blood. Therefore, if the vertex of the lesion is plump, lustrous, and moist, and the base shows gathered Blood, it is a sign that pus will naturally form. Conversely, if the vertex is sunken and grayish-white, and the base shows scattered Blood, it indicates an absence of pus, which is a sign of death.
Generally, on the fourth or fifth day after onset, if the body exhibits tidal fever, the lesion roots are red and the vertices are white, food and drink are taken normally, urination and defecation are regular, and the spirit and breath are calm, this is auspicious. Once the lesions reach the stage of nourishing the paste (yangjiang), one must strictly observe all taboos. This is because during the initial rising phase, the disease duration is short, and Qi and Blood are still strong, sufficient to resist the daily erratic pathogenic qi. By this stage, however, Qi is depleted and Blood is deficient, with spirit and vitality diminished; even slight deviation cannot be borne, especially since the lesions are in the process of flourishing and maturing!
When lesions reach five or six days, toxic pathogens transform into paste. Initially, the color is white, then changes to green, and finally resembles pale wax—plump, lustrous, with red and vibrant bases. The skin feels hard upon touch, while the paste inside is soft, with no other symptoms present; this is auspicious. Red and vibrant bases indicate appropriate Yin Blood; white vertices indicate appropriate Yang Qi. This represents the intersection of Qi and Blood, and the alternating movement of Yin and Yang. Furthermore, if the paste is thick and pure amidst the whitening, it signifies that Blood has transformed and Toxicity is attached, meaning Yang contains Yin. This is the harmonious interaction of Yin and Yang, an auspicious omen. Otherwise, the interior becomes an "Empty Granary," and the exterior resembles dried cornel fruits, with both Qi and Blood exhausted, making survival difficult.
If swelling extends beyond the neck and paste reaches the chest without delay, and the pus is slightly yellow, this is called "True Paste." It is also ideal for the glans to be filled with paste first. The paste on the dorsum of both hands and feet should also be full, as these areas are governed by the Spleen and Stomach; otherwise, during crusting, eating will be impossible and complications likely. When examining lesions, one must carefully inspect the "Mother Lesion" (the primary lesion); if it is lustrous and fully filled with pus/paste, the remaining lesions, though secondary, will ultimately cause no harm. Treatment should primarily focus on tonifying and resolving toxicity.
If a lesion rises and swells with good luster but feels soft and wrinkled to the touch, the paste is incomplete and Qi is weak; immediately apply Baoyuan Tujiang method. Otherwise, crusting will be difficult, leading to itching. If lesions are grayish-white, paste is insufficient, skin is thin and prone to rupture, showing signs of collapse, urgently administer Baoyuan Tang with Guimi. If lesions are red-purple, paste is insufficient, showing signs of dryness and black depression, urgently administer herbs such as Danggui, Chuanxiong, and Shengdi to invigorate Blood, cool Blood, and support paste formation. If lesions throughout the body suddenly turn grayish-white during suppuration, this belongs to Deficiency-Cold; warm and tonify to support the interior. If they turn red-purple, this belongs to Excess-Heat; cool Blood and clear the exterior. However, some cases may be caused by sudden pathogenic invasion, which comes violently and requires careful examination. If lesions have risen and suppurated for seven or eight days but constipation persists, urgently administer Weiqi, Zhike, Shengdihuang, and Huangqin. Otherwise, at the crusting stage, severe fever will occur leading to death.
Pain during suppuration has two causes: Qi stagnation causes pain where lesions lack luster; treatment should promote Qi movement. Blood Heat causes pain where lesions are red-purple; treatment should cool Blood, but not excessively, to avoid stasis of Blood and cessation of paste flow. Dense lesions on the high points of the cheeks, nose tip, and forehead gather toxic vapors from the Five Zang organs and are easily broken. Injury here causes all lesions to subside and toxins to attack internally, so strict protection is essential. If accidentally scratched open, seal the wound firmly and continue internal supportive therapy. If lesions re-emerge and fill normally, or if "Gift Lesions" (extra lesions) appear in empty spaces—small but easy to fill and resolve—it indicates residual toxins are expelling outward, which is also auspicious. Purple-black eye sockets indicate Xiao Du attacking and damaging the Liver, or may result from chronic cough. Early emergence of vitality during suppuration suggests insufficient Yuan Qi; use Baoyuan Tang combined with interior support. Dry lesions indicate Blood Deficiency, requiring Blood nourishment.
Low voice during suppuration is acceptable. However, sudden fever, hoarseness, abdominal distension, and coarse breathing indicate Ding Chuang or Zei Dou at critical limb points; examine urgently, puncture, and seal firmly with You Yanzhi and Zhenzhu Mo. Paste spreading on the head and face with emptiness below indicates toxins floating upward, avoiding fatal danger. Conversely, paste filling limbs first with upper emptiness indicates toxins sinking inward, risking death. Lesions breaking into pits indicate internal collapse; apply Bailong San externally and internal tonification/support. Extensive involvement or multiple clusters indicate ominous prognosis. Thirst, irritability, heat, choking, and wheezing before suppuration begins are ominous. Lesions appearing full but hollow and soft inside are named "Empty Granary Lesions," extremely malignant. If there is clear fluid, raised bases, and red-vibrant blood attachment, urgently rescue with Renshen, Chuanxiong, Danggui, and Renru. Large blisters like beans during suppuration require Baizhu and Fuling to strengthen Spleen/Stomach and drain dampness from the skin. Purple blisters are untreatable. Lesions rotting in patches with non-drying pus require major Qi and Blood tonification plus damp-draining herbs, applied with Baicao San externally. White, crystal-clear lesions without pus require no neglect; watch for itching and collapse on days 11-12, and certain death on days 14-15; early administration of Neituo San with Dingxiang and Ganjiang, or Muxiang San with Nuomi, Renru, and Jiu is indicated. Chills and teeth-grinding on days 7-8 when paste is formed indicate Interior Deficiency; treat with Baoyuan Tang plus Dingxiang and Rougui. Cessation of shaking and scabbing is favorable. After paste fills and heat-toxins resolve, if lesions do not scab/dry for several days during the recovery phase, and color remains original, it is due to Qi Deficiency failing to consolidate or Spleen Deficiency failing to drain dampness; use Bazhen Tang with Spleen-tonifying and water-draining herbs, and lesions will naturally heal.